Annals of Surgical Oncology

, Volume 16, Issue 1, pp 140–146

Pain Palliation in Patients with Bone Metastases Using MR-Guided Focused Ultrasound Surgery: A Multicenter Study


    • Division of OrthopedicsSheba Medical Center
  • David Gianfelice
    • Department of Diagnostic ImagingToronto General Hospital
  • Yael Inbar
    • Department of Diagnostic ImagingSheba Medical Center
  • Alexander Beck
    • Department of RadiologyCharite Hospital
  • Tatiana Rabin
    • Oncology InstituteSheba Medical Center
  • Noga Shabshin
    • Department of Diagnostic ImagingSheba Medical Center
  • Gupta Chander
    • Department of Diagnostic ImagingToronto General Hospital
  • Suzanne Hengst
    • Department of RadiologyCharite Hospital
  • Raphael Pfeffer
    • Oncology InstituteSheba Medical Center
  • Aharon Chechick
    • Division of OrthopedicsSheba Medical Center
  • Arik Hanannel
    • InSightec Ltd.
  • Osnat Dogadkin
    • InSightec Ltd.
  • Raphael Catane
    • Oncology InstituteSheba Medical Center
Palliative Care

DOI: 10.1245/s10434-008-0011-2

Cite this article as:
Liberman, B., Gianfelice, D., Inbar, Y. et al. Ann Surg Oncol (2009) 16: 140. doi:10.1245/s10434-008-0011-2



Noninvasive thermal ablation using magnetic resonance (MR)-guided focused ultrasound (MRgFUS) has been shown to be clinically effective in uterine fibroids, and is being evaluated for ablation of breast, liver, and brain lesions. Recently MRgFUS has been evaluated for palliation of pain caused by bone metastases. We present the clinical results of a multicenter study using MRgFUS for palliation of bone metastases pain.


A multicenter study to evaluate the safety and efficacy of MRgFUS palliative treatment of bone metastases was conducted in patients suffering from painful metastatic bone lesions for which other treatments were either ineffective or not feasible.

Thirty-one patients with painful bone metastases underwent the MRgFUS procedure in three medical centers. Treatment safety was evaluated by assessing the device-related complications. Effectiveness of pain palliation was evaluated using the visual analog pain score (VAS), and measurable changes in the intake of opioid analgesics.


Thirty-six procedures were performed on 31 patients. Mean follow-up time was 4 months. 25 patients underwent the planned treatment and were available for 3 months post-treatment follow-up. 72% of the patients (18/25) reported significant pain improvement. Average VAS score was reduced from 5.9 prior to treatment to 1.8 at 3 months post treatment. 67% of patients with recorded medication data reported a reduction in their opioid usage. No device-related severe adverse events were recorded.


The results suggest that MRgFUS has the ability to provide an accurate, effective, and safe noninvasive palliative treatment for patients with bone metastases.

Copyright information

© Society of Surgical Oncology 2008